Kaiser/Apria bill

This an Apria bill.
This is after I was told (have a document somewhere) that it would be only $158.58.
Can anyone tell me what all these charges are? Esp the CPAP SYSTEM $93.14
This is Kaiser Georgia, senior advantage, so medicare.
I got a resmed Airsense 10 autoset.
I paid $200 for the sleep study which was a waste since I couldn't sleep.
2 office visits at $35 each
And now apria wants $332.80
Also, the delivery was a big mess, between Apria and Fedex I spent so much time,
not to mention the sleep study.
I've seen these for $600 online claiming next day delivery. I should have done that.
TIA

08/11/20 00NR9428 CPAP/BIPAP SUPPLIES $36.24
08/11/20 00NR9428 CPAP SYSTEM $93.14
08/11/20 00NR9428 CPAP/BIPAP SUPPLIES $39.64
08/11/20 00NR9428 CPAP/BIPAP SUPPLIES $15.64
08/11/20 00NR9428 CPAP/BIPAP SUPPLIES $5.20
08/11/20 00NR9428 INSURANCE STATES NON-COVERED SERVICE $158.58
08/11/20 00NR9428 ADJUSTMENT -$15.64
TOTAL AMOUNT DUE: $332.80

While Apria in general is not noted for being a favorite DME by a long shot, don't you think it best to ask them what it all stands for? How can we be sure of anything? We just help each other with Cpap issues.

Tell Apria you need a description of each charge. They have listed the same item several times with different prices. That is pure BS which is what most people get from them. Ask your insurance company if you can use any other DME. If it were me, I would tell them to put their bill and all of their equipment where the sun doesn't shine, get a copy of the prescription and purchase everything from some where else. When my preferred supplier lost their Medicare for two years, I purchased all of my supplies out of pocket rather than deal with Apria or Lynn Care.

As them what those non-covered services were.

"Apria and Lincare"

---otherwise known as Crapria and Lamecare . . .

Since everything is billed separately, I'm guessing that there is a charge for a mask, a mask headgear, a humidifier and the machine itself. Possible that the machine is billed as rent to own.

They are not using standard billing codes, so you need Crapria to tell you what each item is for.

With Kaiser, you have no option other than Crapria. But you can get Kaiser to help you, by contacting patient services and asking them to help you get the itemized billing. Then you can see exactly what you are billing for.

You MIGHT get an EOB from Kaiser (Explanation of Benefits), because it's an outside vendor, and then you can see what is covered and what is not by your Advantage plan. In the old days Kaiser just covered it, but now they issue EOB's. When you call patient services, clarify if that's the amount you owe or should you wait for the EOB. Your out of pocket may be less than you were charged.

My guess is that the $158 charge was for the set up, which is not a covered benefit, whether you requested it or not. You should try disputing that.

DME's are permitted by Medicare to part out the charges. That means if you get a new set up, they charge you for the machine, the humidifier (even if it's integrated and can't be removed), the humidifier chamber, and the hose, the filter, Mask, the cushion, the headgear. Even though they all come bundled together (machine, hose, filter, humidifier chamber come as one thing and mask, cushion, headgear come as one thing) the DME will charge you separately for each part, and the sum is greater than the whole. Even worse, if you are on Medicare Advantage, you will pay the rental fee for the machine monthly until you DIE (or the machine does). On traditional Medicare rentals are limited to 13 months and then you own the machine.

I'm guessing the $93.14 is the rental fee. If that's what you will pay monthly forever, you may have to pay more in January as you will have to meet your Part B deductible again. It's going to cost you nearly $1000 a year forever for a machine you can buy for about $1,700 new and less used. For this reason, you might consider telling them to take back the machine and buy your own.